Abstract
The Drug User Comprehensive Care Policy establishes that care practices should cover biopsychosocial realms. However, evidence reveals an institutionalized practice, in which families prioritize the subject's seclusion from its context of use. This study aimed to understand the implications of psychosocial care and institutionalization in meeting the needs of adolescent crack users and their families. Eleven teenagers and six relatives narrated their experiences through in-depth interviews, which were analyzed in the light of Paul Ricoeur's Phenomenological Hermeneutics. A flow was observed in which teenagers seeking care are initially institutionalized and then referred to replacement services. Thus, there is an urgent need to strengthen the psychosocial care network so that adolescent crack users' care is offered comprehensively, ensuring respect for their fundamental rights, such as the right to freedom and to experience family or community life.
Highlights
Adolescent crack use is the subject of much discussion in both society and media[1,2] and scientific literature
In the political-institutional sphere, guidelines and legal documents aimed at providing care to drug users highlight the harm-reduction strategy as the line of actions in the Unified Health System (SUS) and emphasize the need for an intersectoral and multidisciplinary approach to care, as well as comprehensive care to the most vulnerable populations, such as children, adolescents and teenagers, with development of clinical actions and actions related to family, community, school, housing, work, culture, drug trafficking and violence[17,18]
Research loci were located in Fortaleza, capital of Ceará, and corresponded to a type II Alcohol and Other Drugs Psychosocial Care Center which operates from 8am to 6pm, which follows-up on adolescents through individual and group care, among which was the “harm reduction” group; it should be noted that only the name referred to the harm reduction approach, since it was observed that group meetings were still focused on the achievement of abstinence, and this group name was used to identify the unique group targeting drug users at that service; a type II CAPSi operating from 8am to 6pm; and a reference shelter in the Municipality of Fortaleza-CE
Summary
Adolescent crack use is the subject of much discussion in both society and media[1,2] and scientific literature. Difficulties arise as the supremacy of the clinical health model, using abstinence as the only treatment[5,9,10,29], emphasis on “medical mental control”[30,31] and unprepared professionals to deal with issues related to the user of these substances[32,33] and his family[9,10], as well as resistance to harm reduction[29], which evidences the centrality of care only in biological and psychic aspects While these challenges are part of the day-to-day care of these services, they represent advances in drug user care, since there is an attempt to overcome the drug use approach, once only seen by the legal sector, and the prohibitionist approach, for actions of prevention, health promotion, treatment and reduction of risks and damages associated with harmful consumption, with practices of reception, linkage and establishment of therapeutic groups[14,18,24,34]. This study aimed to understand the implications of psychosocial care and institutionalization in meeting their needs
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